Specialist Gender Services for Children and Young People – Progress Report

Conclusion

57. The Scottish Government acknowledges that progress in reducing waiting times to access specialist children and young person gender identity healthcare within NHS Scotland has remained slower than desired.

58. The provision of Scottish Government financial support has enabled significant new work in the service, however, despite the best efforts of clinical and management staff directly involved in delivering this service capacity remains limited and waiting times from referral to first appointment long. As experienced in England and Wales, evidenced by the Cass Review findings and NHS England's subsequent response to it, the ability of health systems to step up clinical capacity in the short term to meet demand has proven difficult. The factors behind this are varied and include scarcity of clinical specialists, high demand in the form of large waiting lists and negative public narratives associated with this field of healthcare contributing to it not always proving an attractive role, when compared to other roles competing for a similar skillset.

59. Nonetheless, the success of some adult gender identity clinics in Scotland have seen in recruitment in recent years following changes to support multidisciplinary working, secure and defined roles with support, and wider engagement with other clinical areas aligns with the findings of the Cass Review in suggesting that concrete action that can be undertaken to make working in these roles more attractive, ultimately reducing recruitment and retention challenges going forward.

60. The range of actions progressed to date including the actions of the 2021 Framework, the work of the MDT published in July, ongoing engagement in research and new commissioning of services already underway, represent a refreshed opportunity to build on work to date and advance delivery of these services to provide high-quality, person-centred specialist care in this field.